Increased pre-school overweight and obesity prevalence between 2004 and 2013 is associated with appetite, eating frequency and supportive facilities: the Jiaxing Birth Cohort in China.

BACKGROUND AND OBJECTIVES: Childhood obesity is increasing. However, little is known about the changes in di-etary factors and supportive facilities associated with childhood obesity. We aimed to document the changes in various dietary factors and supportive facilities and their associations with obesity among pre-school children.

METHODS AND STUDY DESIGN: Among 42,531 children 4-5 years old, recruited between 2004 and 2013 in the Jiax-ing Birth Cohort, we examined the changes in the prevalence of various dietary factors and supportive facilities and overweight/obesity over 10 years. We used logistic regression to investigate the cross-sectional association between these factors and childhood overweight/obesity risk, adjusting for potential confounders.

RESULTS: The prevalence of childhood overweight/obesity increased steadily from 11.8% (boy: 14.8%; girl: 9%) during 2004-2005 to 18% (boy: 21.4%%; girl: 15%) during 2012-2013. The prevalence of meal/snack frequency 3 times /day decreased substantially from 23% during 2004-2005 to 8% during 2012-2013, with more children having 5 times /day: from 32% to 45.6%. Children with a fair/bad appetite, compared with those with a good appetite, had a 45% (OR: 0.55; 95% CI: 0.49, 0.62) lower risk of overweight/obesity. Children with a meal frequency >=6 times/day (compared with 3 times/day) had a 0.12 (95% CI: 0.03, 0.2) higher BMI-z-score.

CONCLUSIONS: The prevalence of childhood overweight/obesity has increased substantially within a decade in southeast China. A better appetite and greater eating frequency were associated with the increased prevalence.